Medical Billing Compliance Auditor
NorthStar Anesthesia
full-time
Posted on:
Location Type: Office
Location: Irving • Texas • United States
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Job Level
About the role
- Under general supervision, ensures that compliance initiatives are met for all the NorthStar client sites.
- Responsible for investigating potential compliance issues linked to clinical and billing activities.
- Support the compliance team by performing quality, internal audits and monitoring essential services in compliance with federal and state laws and regulations.
- Coordinates with Compliance Director and Chief Compliance Officer on any billing compliance investigations.
- Reviews and audits documentation in the medical records and charges submitted including CPT and ICD-10 information to ensure compliance.
- Reviews charge information, claim forms, and insurance correspondence to determine if coding, billing, claim follow-up, payment receipts, posting activities, and credit processing are being performed in an accurate and timely manner and is supported by documentation.
- Analyzes billing trends to identify areas of non-compliance and prepares regular reports on audit findings to Compliance Director.
- Collaborates with the Compliance Team to develop annual audit work plans.
- Educates providers when deficiencies in documentation and code selection are identified.
- Develops corrective action plans and participates in compliance investigations as needed.
- Promote NorthStar Anesthesia’s Core Values.
- Demonstrates regular, reliable and predictable attendance.
- Performs other duties as required.
Requirements
- 1 to 3 years applicable compliance experience, in healthcare industry preferred
- CPC certification required
- 4 years of healthcare billing and coding experience preferred.
- Excel and Power Point knowledge preferred
Benefits
- Competitive salary
- Flexible work hours
- Professional development budget
- Home office setup allowance
- Global team events
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
CPT codingICD-10 codingbilling complianceinternal auditsquality assurancedata analysiscorrective action plansdocumentation reviewclaim follow-uppayment processing
Soft Skills
collaborationcommunicationattention to detailproblem-solvingeducational skillsorganizational skillsreliabilitypredictability
Certifications
CPC certification